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Street Talk Newsletter

When You See Bipolar

You respond to a dispatch for a domestic disturbance. Once you’re on the scene and talking to the people involved, you might discover that bipolar disorder is the underlying factor.

As you read this article, here are a few things to know:

Except in cases where a person’s depression phase has become so bad that he/she attempts suicide, it’s more likely someone comes to your attention while they’re in the manic phase. Reasons can include:​

the person’s happy mood and high energy escalate over the top and turn aggressive

neighbors complain about loud activity all hours of the night because the person has little need for sleep or awareness of how their behavior affects anyone else

the person engages in lots of risk-taking behavior, such as reckless driving, shoplifting, excessive gambling, or substance use

In the early upswing of the manic phase, all that energy and sense of grandiose potential can feel really, really good. They enjoy the feeling; they believe they can control it, even when past episodes say otherwise. Unless someone has a lot of insight into their illness, it can be very difficult in this phase of the mania to encourage the person to get psychiatric help.

It’s not uncommon for someone in the manic phase to view anyone trying to talk them into seeking help as “just getting in my way of what I need and want to do.”

Another thing to keep in mind is that spouses, other family members and friends also struggle when their loved one’s symptoms are not well-managed. By the time you encounter the family or friends, they are probably stretched to their limit in coping with the roller-coaster that bipolar can be.

The Communicating During Crisis and the Resources articles offer more information for you as well as those you’re trying to assist during a mental health call.

What is Bipolar Disorder?

Bipolar disorder - sometimes still referred to as manic depression – involves one or more episodes of serious mania and depression. It causes a person’s mood to swing from excessively “high” and/or irritable to sad and hopeless, with periods of a normal mood in between. It’s estimated that more than 2 million Americans experience this illness.

The disorder typically begins in adolescence or early adulthood and continues throughout life. Often, people don’t recognize it as an illness, and those who have it can go undiagnosed and untreated for years.

Bipolar disorder can be extremely distressing and disruptive, both for the person who has, as well as spouses, family members, friends and employers. Although there is no known cure, it is treatable. This means individuals have the potential for successful relationships and meaningful jobs. The combination of medications and psychotherapy helps the vast majority of people return to productive, fulfilling lives.

What Are the Symptoms?

Bipolar disorder is often difficult to recognize and diagnose. It causes a person to have a high level of energy, unrealistically grandiose thoughts or ideas, and impulsive or reckless behavior. These symptoms can feel good to a person, leading to denial that a problem exists.

Another reason bipolar disorder is difficult to diagnose is that its symptoms can appear to be part of another illness or attributed to other problems such as substance abuse, poor school performance, or trouble in the workplace.

The symptoms of mania, which can last up to three months if untreated, include:

Extreme “high” or euphoric feelings; a person feels “on top of the world” and nothing, including bad news or tragic events, can change this “happiness”

Easily irritated or distracted

Decreased need for sleep, possibly going for days with little or no sleep without feeling tired

Unrealistic beliefs in one’s ability and powers; feelings of exaggerated confidence or unwarranted optimism. This can lead to over-ambitious work plans and the belief that nothing can stop him or her from accomplishing any task.

Uncharacteristically poor judgment; poor decisions that can lead to unrealistic involvement in activities, meetings and deadlines, reckless driving, spending sprees and foolish business ventures

Sustained periods of behavior that are different from usual; a person might dress and/or act differently than he or she usually does, become a collector of various items, become indifferent to personal grooming, become obsessed with writing, or experience delusions

Heightened sexual drive and activity

Abuse of drugs, particularly cocaine, alcohol or sleeping medications

Provocative, intrusive, or aggressive behavior, in which a person could become enraged or paranoid if his or her grand ideas are stopped or excessive social plans are refused

Some people experience periods of normal mood and behavior following a manic phase; however, the depressive phase will eventually appear.

Symptoms of depression include:

Persistent sad, anxious, or empty mood

Sleeping too much or too little, middle-of-the-night or early morning waking

A specific genetic link has not yet been found, but studies show that 80% to 90% percent of people with the illness have at least one relative with some form of depression.

It’s also possible that people inherit a tendency to develop the illness, which can then be triggered by environmental factors, such as distressing life events.

Bipolar disorder indicates a biochemical imbalance that alters a person’s moods. This imbalance is thought to be caused by irregular hormone production or due to a problem with certain chemicals in the brain, called neurotransmitters, that act as messengers to our nerve cells.

Treatment

Treatment is critical for recovery. A combination of medication, professional help and support from family, friends and peers help individuals with bipolar disorder stabilize their emotions and behavior.

Most people with bipolar disorder can be treated with medication. A common medication, Lithium, is effective in controlling mania in 60% of individuals with bipolar disorder. Other types of mood-stabilizers, anti-convulsant, or anti-psychotic medications might be prescribed. Benzodiazepines are sometimes prescribed for insomnia, but they carry a risk for abuse and dependency.

Another critical component of treatment is education, guidance, and support from a mental health professional to help deal with personal relationships, maintain a healthy self-image and ensure compliance with medication treatment.

Support groups can also be a valuable resource for learning coping skills, feeling acceptance and avoiding social isolation. Friends and family can join support groups specifically designed to help them better understand the illness and continue to offer encouragement and support to their loved ones.